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1gradelevelreading.net  /  @readingby3rd  /  #GLReading

Upcoming WebinarsGLR Campaign Learning Conversation: 

Community Data Warehouse

Tuesday, March 26, 3 p.m. ET/12 p.m. PST

Register

Housing Partner Discussion Series #3: 

Innovations in Public Housing Around Early School Success

Tuesday, May 7, 2 p.m. ET/11 a.m. PST

Register

Save the Date — Science Matters!

Tuesday, June 11, 2 p.m. ET/11 a.m. PST

gradelevelreading.net / @readingby3rd / #GLReading

Early Relational HealthAn Essential Foundation for Early School Success

March 12, 2019

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About Science Matters! Series

The Science Matters! webinar series will promote capacity building, network 

building and road testing of community‐built models around early learning 

and parent success. Funders and their local teams will:

• gain new knowledge and insights about the science of brain 

development and early learning;

• increase their level of urgency to promote and support early brain 

development in ways that take the research to action; and

• prepare to act, lead and invest in a suite of tools, programs and strategies 

to ensure that parents are equipped with the knowledge, confidence and 

supports to be successful in their essential roles as brain builders.

3gradelevelreading.net  /  @readingby3rd  /  #GLReading

Webinar Series Approach

• Bring together 2–3 members of your local coalition to co-view the presentation

• Engage the webinar speakers in Q & A

• Following the webinar, engage in a discussion with your teams to identify at least one idea you would be willing to explore and test

4gradelevelreading.net  /  @readingby3rd  /  #GLReading

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5gradelevelreading.net / @readingby3rd / #GLReading

Ellen GalinskyChief Science Officer, Bezos Family FoundationCo-Sponsor of the GLR Science Matters! Series

Welcome and Introduction

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Early Relational HealthFoundations for Health, Early Learning and Future Wellbeing

Science Matters WebinarCampaign for Grade Level ReadingMarch 12, 2019

David Willis, M.D., Executive Director, Perigee Fund

Clinical Transformations: Campaign for Grade Level Reading Webinar on Relational Health

Dayna Long, MD UCSF Benioff Children’s Hospital OaklandDepartment of Community Health and EngagementMarch 12, 2019

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Dina Lieser Early Childhood Systems Program Director and Team Lead, Division of Home Visiting and Early childhood System (DHVECS)Maternal and Child Health Bureau (MCHB)Health Resources and Services Administration (HRSA)

Home Visiting and Early Childhood SystemsCampaign for Grade Level Reading Webinar on Relational Health

March 12, 2019

Why is Early Relational Health a New Concept?

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David Willis, M.D., Executive Director, Perigee Fund

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Early Relational Health

A multi-dimensional and dyadic construct established by the parent-child interactions during the First 1000 Days of life that build lifelong health, early learning, social-emotional capacities, self-regulation and resiliency.

Physical Health

Biological, Genetic, Prenatal Factors

DevelopmentalHealth

Social-economic, educational, and

community involvement

Early Relational Health

Attachment and Relational Patterns (Special attn. to ACE’s, current and historical

trauma)

What is the Science Behind Early Relational Health? What are its Guiding Principles?

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Bio‐behavioral synchrony and dyadic neurodevelopment

Feldman, Ruth., The Neurobiology of Human Attachments, Trends in Cognitive Science, Feb 2017.

Behavioral Synchrony

Synchronized behavior in gaze, affect, vocal, and touch

Mother-specific Father-specific

Heart Rate Coupling

Synchronized HR during synchronized interactions

Endocrine Fit

Coordinated OT response following contact

Coordinated cortisol response to stress

Brain to Brain Synchrony

Coordinated brain oscillations in alpha and gamma rhythms

Bio‐behavioral synchrony in human attachments

• A dyadic and two-generational focus

• A bi-directional perspective for parent-child development with the centrality of shared positive affect

• Foundational to equity, resiliency, recovery and protection

• Health, early learning and social-emotional competences are outcomes of ERH

• Science-based, strength-based and family-centric

• Recognizes cultural variability in parenting, but sees ERH as universal

• A paradigm shift for early childhood, society and our culture

Principles for Early Relational Health

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What are Best Practices in Early Relational Health?

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Dayna Long, MD UCSF Benioff Children’s Hospital Oakland

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Question:

How can we effectively and meaningfully

engage and support the Johnson Family, our providers, pediatric clinics and communities 

to promote wellness?

Survey Data from Children’s Hospital Association

N=213

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A lifelong commitment to self‐evaluation and self‐critique

Redressing the power imbalances in the patient‐physician dynamic

Developing mutually beneficial partnerships with communities on behalf of individuals and defined populations

Advocating for and maintaining institutional accountability

Cultural Humility

Tervalon M, Murray-Garcia J: “Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education, “Journal of Health Care for the Poor and Underserved 1998; 9(2):117-124

Cultural HumilityDeveloped by Doctors Melanie Tervalon and Jann Murray‐Garcia, cultural humility is…

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Primary Care Interventions

FINDing Joy through Care Coordination

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Trauma-Informed Systems Initiative

Healing Ourselves, Our Communities

and Our City

UCSF BenioffChildren’s Hospital Oakland 

TRAUMA‐INDUCING TO TRAUMA‐REDUCING

TRAUMA‐INDUCING TO TRAUMA‐REDUCING

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In collaboration with Genentech Charitable Giving, 

the Center for Care Innovations (CCI) launched a 

program called Resilient Beginnings Collaborative: a 

24‐month learning program dedicated to addressing 

childhood adversity and strengths in pediatric safety 

net care settings.

© 2018 Center for Care Innovations  /  3

Maternal, Infant and Early Childhood Home Visiting (MIECHV)

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Dina Lieser Early Childhood Systems Program Director and Team Lead, Division of Home Visiting and Early childhood System (DHVECS)Maternal and Child Health Bureau (MCHB)Health Resources and Services Administration (HRSA)

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I. Maternal and Newborn Health

II. Child Injuries, Maltreatment, and 

Reduction of ED Visits

III. School Readiness and Achievement

IV. Crime or Domestic Violence

V. Family Economic Self‐Sufficiency

VI. Coordination and Referrals

Benchmark Areas

Preterm Birth; Breastfeeding; Depression Screening; Well‐Child Visit; Postpartum Care; Tobacco Cessation Referrals

Performance Measures

Safe Sleep; Child Injury; Child Maltreatment 

Parent‐Child Interaction; Early Language and Literacy Activities; Developmental Screening; Behavioral Concerns

IPV Screening

Primary Caregiver Education; Continuity of Insurance Coverage; Insurance Coverage

Completed Depression Referrals; Completed Developmental Referrals; IPV Referrals

MIECHV Benchmark Areas

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Early Childhood Comprehensive Systems (ECCS) Impact

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• AIM‐ASPIRATIONAL GUIDING STAR: 

Thrive by Three.  

Improvements in developmental skills of 3 year olds by 25% within 5 years

• Drivers:

Family Partnership

Universal Developmental Promotion

Social Determinants of Health

Linked and Coordinated Systems

Policy

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ECCS Aims• Build leadership and expertise in CQI

• Achieve collective impact at state, county and community level

• Implement 2‐generation strategies to integrate vertically within sectors and horizontally across sectors

• Develop and adopt early childhood system process measures and outcome indicators to measure population impact around children’s developmental health and family well‐being

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Opportunities and Challenges

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• Reach Out and Read (ROR)

• Promoting First Relationships in Pediatrics (PFR)

• Triple P Positive Parenting Program

• Video Interaction Project (VIP)

• Early Relational Health Screen (ERHS) and video feedback

• Welch Emotional Connection Scale (WECS)

• Filming Interactions to Nurture Development (FIND)

• Evidence-based home visiting

Early Relational Health in actionExemplars for promotion, prevention and early intervention

What Changes in Practice, Systems, Policy are Needed?

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Systems Thinking

• Approach to grappling with adaptive problems in complex environments with the aim of making enduring social change at scale

• Seek health, not “mission accomplished”

• See patterns, not just problems

• Unlock change. Don’t impose it

• Plan to adapt. Don’t stay the course

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Conditions of Systems Change

4040

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Marching Orders

Q & A

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43gradelevelreading.net  /  @readingby3rd  /  #GLReading

Upcoming WebinarsGLR Campaign Learning Conversation: 

Community Data Warehouse

Tuesday, March 26, 3 p.m. ET/12 p.m. PST

Register

Housing Partner Discussion Series #3: 

Innovations in Public Housing Around Early School Success

Tuesday, May 7, 2 p.m. ET/11 a.m. PST

Register

Save the Date — Science Matters!

Tuesday, June 11, 2 p.m. ET/11 a.m. PST